Department of Orthopedic Surgery, Yeungnam University Hospital, Daegu, Korea.
Clin Orthop Surg. 2011 Mar;3(1):69-76. doi: 10.4055/cios.2011.3.1.69. Epub 2011 Feb 15.
To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with a staged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique.
From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classification II, 3; IIIA, 1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fixator were performed within 24 hours and the mean interval from injury to definitive surgical treatment was 15 days (range, 6 to 52 days). Eight weeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year.
The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was 84.5 points. At the last follow-up, there was no non-union, angular deformity > 5°, shortening > 10 mm or infection. In 10 patients, 2 patients had a superficial wound infection, and another 2 patients showed limitation of ankle joint motion.
This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving high functional recovery with good healing and low complication rates in patients with an open distal tibia fracture.
评估采用外侧微创钢板接骨术（MIPO）技术分期治疗开放性胫骨远端骨折患者的影像学和临床结果。
2007 年 1 月至 2009 年 6 月，10 例开放性胫骨远端骨折患者（Gustilo-Anderson 分类 II 型 3 例，IIIA 型 1 例，IIIB 型 6 例）采用分期治疗方案进行治疗。初次清创和应用外固定器在 24 小时内进行，从损伤到确定性手术治疗的平均时间间隔为 15 天（范围 6-52 天）。8 周后，3 例患者进行了额外的植骨。随访时间超过 1 年。
平均骨折愈合时间为 21 周（范围 17-28 周），爱荷华踝关节评分平均为 84.5 分。末次随访时，无骨不连、畸形>5°、短缩>10mm 或感染。10 例患者中，2 例有浅表伤口感染，2 例有踝关节活动受限。
采用外侧 MIPO 技术的分期治疗方案是治疗开放性胫骨远端骨折的一种有效替代方法，可获得较高的功能恢复，愈合良好，并发症发生率低。
